An educational intervention program on knowledge about oral hygiene measures

Introduction: Oral health knowledge is considered to be an essential prerequisite for health-related practices1, there is an association between increased knowledge and better oral health2,3. Those who have assimilated the knowledge and feel a sense of personal control over their oral health are more likely to adopt selfcare practices4. Now-a-days oral disease can be considered as a public health problem due to its high prevalence and significant social impact. Chronic oral disease typically leads to tooth loss, and in some cases have physical, emotional and economical impacts5. Physical appearance and diet are often worsened and the pattern of daily life and social relations are also often negatively affected. These impacts lead in turn to reduce welfare and quality of life. To minimize these negative impacts of chronic oral diseases, there is a clear need to reduce harmful oral health habits. Such a reduction can be achieved through appropriate health education program5,6 . Bangladesh is a developing country with a vast population. Many people of this country live below poverty line. They possess a harmful life style for health, especially oral health. Dental problem is still a significant public health problem in both developed and developing countries. Good oral health is a key for ensuring overall well being. Our teeth play


An educational intervention program on knowledge about oral hygiene measures
Karim F 1 , Begum J 2

Introduction:
Oral health knowledge is considered to be an essential prerequisite for health-related practices 1 , there is an association between increased knowledge and better oral health 2,3 .Those who have assimilated the knowledge and feel a sense of personal control over their oral health are more likely to adopt selfcare practices 4 .Now-a-days oral disease can be considered as a public health problem due to its high prevalence and significant social impact.Chronic oral disease typically leads to tooth loss, and in some cases have physical, emotional and economical impacts 5 .Physical appearance and diet are often worsened and the pat-tern of daily life and social relations are also often negatively affected.These impacts lead in turn to reduce welfare and quality of life.To minimize these negative impacts of chronic oral diseases, there is a clear need to reduce harmful oral health habits.Such a reduction can be achieved through appropriate health education program 5, 6 .Bangladesh is a developing country with a vast population.Many people of this country live below poverty line.They possess a harmful life style for health, especially oral health.Dental problem is still a significant public health problem in both developed and developing countries.Good oral health is a key for ensuring overall well being.Our teeth play an important role in our daily lives.It increases the beauty of the face, helps in digestion of food by chewing and grinding and enables to articulate and pronounce words correctly while talking.In order to establish oral hygiene as an important prophylactic measure influencing successful protection of oral health of the whole population, it is necessary to inform as many people as possible about oral hygiene effectiveness and its necessity in preventing oral and dental diseases; to develop the habits of regular oral hygiene maintenance in the people.Regarding high prevalence of dental problem in population, the issue of prophylaxis is of great significance.In that respect, health education should point out to the significance of proper and regular oral hygiene, all aimed at preventing dental diseases.The purpose of the study is to assess the knowledge about oral hygiene among the population in a selected community before and after health education.The information from this study will help policy makers to identify the information gaps and formulate guidelines and act as a baseline for further study.

Methodology: Study Design:
This was a quasi-experimental type of study.In this study the outcome of educational intervention is obtained by comparing pre and post intervention on knowledge of the same group of people.The study was carried out at South Pirerbag, Dhaka.The study population was selected randomly irrespective of age, sex and religion.Participation was voluntary.The sample size was 106.The sample was collected by non probability purposive sampling.Data Collection Procedure: A structured questionnaire was developed based on the objectives and variables of the study.It was finalized after modification and correction based on the findings of questionnaire pretesting.Before collection of data permission was taken from the respondents.The purpose of the study was explained to the respondents prior to administering the interview.With the consent of the respondents data was collected by face to face interview by using Bengali version questionnaire.The study population was interviewed twice with the same sets of structured questionnaire.At first baseline data were collected.After collection of baseline data, health education program was conducted by preparing a lesson plan according to the objectives.Second phase of data was collected after intervention.The privacy of the respondents was maintained strictly.This study was not involved any physical, mental and social risk of the respondents.

Data Processing And Analysis:
After collection of information through questionnaire, the data were coded, entered and analyzed in a computer.The findings of the study were presented by frequency, percentage and table and data analysis was done using statistical package for social sciences or SPSS version 14 (Chicago, IL, USA).

Educational Intervention Program
According to the baseline information an educational curriculum was prepared with necessary educational materials for health education intervention program.A total 106 respondents were selected purposively.They were divided into seven groups, each groups consist of 15 respondents.The allocated time was thirty minutes for each group.The respondents were informed previously according to scheduled date and time.Health education intervention session was conducted using various methods (lecture, group discussion) and media (poster, model of teeth, tooth brush) for dissemination of knowledge.The program was evaluated on the basis of change in knowledge about oral hygiene before and after intervention by applying structured questionnaire.Post intervention data collection was started after 15 days of educational intervention program.

Results:
In this study 106 respondents were participated with mean age 46.25 ± 11.27 years.Majority of them had only school level education and others were illiterate.Mean monthly family income was 7520.94 ± 320.40 Taka.Among the respondents 61.32% were male and 38.68% were female.Among 106 respondents, before intervention 64.15% respondents told that teeth should be cleaned twice daily and 25.47% respondents told once daily; whereas after intervention it was changed into 91.51% and 4.72% respectively.(Table -

Discussion:
This educational intervention study was carried out among the general population in a selected community with a view to assess the effect of health education about oral hygiene measures.A total 106 respondents were interviewed with structured questionnaire and an educational intervention program was conducted which was evaluated after intervention.
Among Though after intervention the percentage of the respondents on oral hygiene knowledge slightly improved, but the increase percentage is not satisfactory.The concerned authority can play a vital role to improve the knowledge on everyday science and per-sonal hygiene including oral hygiene among the mass population in Bangladesh.Hence we may get a generation free of oral diseases and a good oral health.

Conclusion:
The change to healthy attitude and knowledge can be occurred by giving adequate information and motivation to the respondents.Therefore dental health education is needed focusing on the special needs of the population to improve their quality of life.

Recommendation:
On the basis of the findings of the present study following recommendations were drawn: Community oriented intervention program for community people should be arranged.
Provide effective and appropriate messages on oral health through mass media such as radio, television, newspaper, folk song, billboard etc. Educational Intervention program should be arranged at school, work place and hospital.Include a chapter on oral hygiene and practices in the health education curriculum at school so that the school going children improve their knowledge and practice and dissemination of information among their family members.
Regular training among the community health workers to educate the community people about oral health.
Train up the community leaders about proper oral hygiene so that they can build awareness to the community people through disseminating information.

Table - 1: Distribution of the respondents by knowledge on frequency of tooth cleaning before and after intervention (n=106)
1).

Table - 5: Distribution of the respondents by knowledge on cleaning teeth after every meal before and after intervention (n=106)
after intervention 63 ( 66.32%) respondents told that smokeless tobacco cause ulcer, stain, bad breath, loss of taste and cancer all, 9 (9.47%) told both bad breath and stain of tooth and 6 ( 6.32%) told cancer only.
Table -8 shows that before intervention 23 (32.40%) respondents did not know what kind of disease occur due to smokeless tobacco consumption.12 (16.90%)respondents told that smokeless tobacco cause both bad breath and stain in tooth, 7 (9.86%)told cancer, 9 (12.68%)told bad breath only; where

Table - 8: Distribution of the respondents by knowledge on type of disease occur in the mouth due to smokeless tobacco use before and after intervention
by Hebbal et al. in Belgaum, India 9 .Similar result was found in the study done by Shenoy in India, Thomas in Kerala and Tewari in Ambala 10-12 .